Bile duct stone not seen during ERCP

My father is in his 70s, has had severe pain  and weight loss for several months, MRI showed stone in bile duct, has had 2 ERCP procedures, the stone was not visible during either of these, but his specialist cut the bile duct and has assured him that it would have come out.  His pain has now increased dramatically along with nausea and sickness.  His specialist seems at a loss .... we are at our wits end. Cat scans, MRI and blood tests all came back normal apart from showing the bile duct stone.   Could he have S.O.D??  How do we know that the stone has definitely gone when it was never seen during the ERCP.  Any help please


This discussion is related to Stone in bile duct (gallbladder already removed).

[CalGal]

This could be SOD. Were the pressures tested during the ERCP? The only situation in which the sphincter should be cut according to current medical studies is when the pressures are raised. It is possible that cutting the duct might result continuing problems. You may want to have your father evaluated by another specialist in SOD and biliary issues.

Just because the sphincterotomy was performed does not assure that the stone passed. you may want to consider having a follow-up MRCP to look at the structural characteristics of the biliary system in its current state.

With SOD the use of narcotic-based meds can make the situation worse. You may want to ask the doc about the use of specific anti-spasm meds or calcium channel blockers to help reduce the pain.